Metoclopramide-Induced Extrapyramidal Side Effects are Augmented by Domperidone

Abstract

Metoclopramide is perhaps one of the most common causes of drug-induced movement disorders. It is indicated in several conditions such as nausea, vomiting, diabetic gastroparesis, small bowel intubation, and gastroesophageal reflux. We report a case of a 15-month-old Saudi boy who was first treated for sudden and persistent nausea and vomiting, accompanied by high-grade fever 39.9°C. The physician started treating him with domperidone (Motilium 1 mg/mL oral suspension) 0.25 mg/kg immediate (stat) dose and, hence, he received a total stat dose of 2.5 mg. He was also prescribed paracetamol suppositories for fever at a dose of 15 mg/kg. Later on, another pediatrician decided to administer a stat dose of metoclopramide at approximately 6 p.m. and he received only a single dose of 1 mg metoclopramide I.V. (Primperan), which stopped the nausea and vomiting instantly. The baby was brought back to the same government hospital at 12 a.m., presenting typical extrapyramidal symptoms (EPS). He was treated successfully with only diazepam.